Pediatricians could soon be asked to notify the Allegheny County Health Department when they diagnose youngsters with a certain bacterial infection that is resistant to standard antibiotics.

The reports could help health experts get a better handle on how prevalent methicillin-resistant Staphylococcus aureus, or MRSA, is in the community, said Dr. Bruce Dixon, director of the Health Department.

The Board of Health will decide at its meeting tomorrow whether to implement the notification plan.

"There aren't that many [cases] and I don't think it's a major problem, but we wanted to see in a more global way if it was becoming more common," Dr. Dixon said. "People have told us when they've had a case, but we wanted to make it more formal."

Reporting by doctors and laboratories still would be voluntary, not required, he added. Schools have already been asked to notify the Health Department when cases occur.

Dr. Dixon said that samples could also undergo genetic tests to determine whether the MRSA strain originated in a hospital or the community, and to see whether there has been any crossover between the two kinds.

Dr. Marian Michaels, an infectious disease specialist at Children's Hospital, said that community-acquired MRSA infections have been on the rise in the region for about two years. Outbreaks have occurred in several schools, often among football players and wrestlers.

"It was not unexpected to see it in that group of people first because they're often getting brush burns on their arms and legs," she said. Skin breaks, close contact and sharing of equipment provide a way for the bacteria to spread between individuals.

Any skin infection, including MRSA, can make the affected area warm, tender, red and swollen. People often think that they were bitten by a spider or other insect, Dr. Michaels said. Some lesions get better with warm soaks and good cleansing.

But "just looking at it, you can't tell if it's the methicillin-resistant or old-fashioned, sensitive Staph aureus [bacteria]," she noted.

Dr. Michaels advises primary care doctors to obtain a sample of pus from the lesion so that the bacteria can be cultured and tested to determine which drugs will be effective.

When there is no pus, the nose can be swabbed to check if the patient is a carrier of the resistant germ, she said.

If MRSA cases have been occurring in the community, particularly among the patient's family and friends, the doctor should probably prescribe an antibiotic that's known to fight the infection, Dr. Michaels said.

But indiscriminate use of those antibiotics could lead to more resistance, she warned.

If the infection doesn't improve after several days of treatment, seek medical advice.